Labiaplasty for improved comfort, convenience, and sensation

Labiaplasty is an office procedure performed in our office under local anesthesia. Labia remain swollen for two weeks or longer, and comfortable return to athletic and sexual activity usually two to four weeks. Results favorable for many women: Less worry about exposure in sparing or tight fitting styles of clothing, less friction during competitive and non-competitive sports and exercise, and improved sexual experience and/or orgasm. This patient is shown before and three months after her procedure. As you can see, no visible scar.

“The ‘Vagina Whisper’ Will See You Now!”

The “Vagina Whisperer” Will See You Now

Within the past 5 years, we’ve seen a sort of a-ha moment happening for women. It’s become okay for women to talk about their labia and their vagina with their doctors. It’s become okay for women to finally talk about sex and the real issues they’re having!

“I’m a surgeon, but don’t ask me for surgery”

Surgeons are physicians specializing in evaluation and management of problems treated and/or cured by surgery. Cognitive (thinking) and technical (operating) skills are required. To become a surgeon, I graduated at the top of my four year college class, near the top of my four year medical school class, then apprenticed as a surgical resident days, nights, weekends, and holidays in hospitals around the United States for ten years after medical school. Many subjects are mastered, including a foundation of basic sciences such as anatomy (gross and microscopic), biochemistry, physiology (healthy function of the body), pathology (diseases), microbiology (bacteria, fungi, and viruses), pharmacology (drugs), genetics, neurosciences, psychiatry, etc. During my decade of residency, benchmarks were achieved each year to advance to subsequent higher levels of responsibility and independence. We learned about the surgical specialties, saw thousands of patients, and worked with doctors in every area of medicine. Oral and written examinations administered by the American Board of Surgery and the American Board of Plastic Surgery were passed. Training and exams were rigorous and uncompromising, designed to assess cognition (knowledge, reasoning, and judgment), technical skills, and professional ethics. All are critically important for surgery. In practice for over twenty years, I still qualify annually by reporting continuing medical education and occasionally taking maintenance of certification examinations.

Why does this matter? Because quality outcomes can only be delivered in the context of high ethical, scientific, and technical standards. Treatments we recommend should have the highest possible benefit to risk relationship: The most upside and the least downside. Because everyone is different and unique, a treatment that is beneficial for one person may be a disaster for another. To differentiate among patients what is best for one individual, we surgeons must ask questions, i.e. learn about each patient in consultation. We must examine our patients physically to know their anatomy, to understand which treatments may work best and which may not be indicated. Sometimes, we must check additional blood tests, X-rays, or other studies for more information. All that data is analyzed, options for treatment are considered, discussed with patients, and a mutually agreeable treatment plan developed. Every patient should be approached with this stepwise sequence of gathering and verifying information, analyzing the information, prioritizing possible solutions based on the presentation, finalizing a plan, and only then, implementing treatment.

As an aesthetic plastic surgeon, our office fields constant calls for this peel or that product, the latest lunchtime lift, mini-tuck, or new device, diet, or implant. Usually, callers read about it in a magazine, saw a TV show (“The Doctors”), or saw advertising. Media is a business, and media exposure is bought by business. The end game of business is sales. Sales are not necessarily about what’s best for YOU. Sales are about revenue for the manufacturer, producer, and/or marketer of techniques, devices, products, and services. We implement new information and technology in our treatments, but only as appropriate in the upside to downside calculation for each patient.

Nobody comes to us for surgery, people come for results. We specialize in results, not in procedures. Procedures are only means to an end. Often, there are several possible operations that will achieve slightly different results. Results are the solution to a problem. The problem must be properly analyzed first, and treatment solutions follow. Inquiring about solutions, whether a new product or a new procedure, before understanding and analyzing the problem is backwards.

By all means, ask about new treatments and technologies, we’ll answer your questions. As a layperson, you’re not expected to know science, biotechnology, and the human body. But you DO know, more than anyone else can ever know, what bothers you when you look in the mirror or at a photograph of yourself. You know your problem, and in our office, that’s all you need to know. We’ll discuss the rest, and decide with you which solution is the best.

7 Differences: Plastic Surgeon vs Cosmetic Surgeon

You want the best result, and the best surgeon. How can you tell? Truthfully, the surgeon with the highest standards for his or her own performance reliably holds the highest standards across the board. The best surgeon will have the highest level of training and certification, and will offer you the best care, and likely the best result.

So how can you know? Plastic surgeon or cosmetic surgeon? The differences may surprise you. Because of common misconceptions surrounding cosmetic plastic surgery, you should understand what’s behind the scrubs and the white coat.

Operations that improve the human body are called Plastic Surgery after the Latin plasticus: that may be molded. The two types of plastic surgery are reconstructive surgery, after injuries, and aesthetic (cosmetic) surgery, to improve appearance. Cosmetic surgery is only a part of plastic surgery, but to perform it well, the physician must be fully trained in the entire specialty.

1. All plastic surgeons are cosmetic surgeons but not all cosmetic surgeons are plastic surgeons.

Board Certified Plastic Surgeons have more training and ARE qualified to perform both reconstructive and aesthetic/cosmetic surgery.

A Cosmetic Surgeon is NOT certified to perform plastic/reconstructive surgery.

4. Is my surgeon trained to perform my surgery?

After graduating medical school, a Board Certified Plastic Surgeon must be selected among many applicants for residency training in Plastic Surgery. If chosen, the physician learns how to be a surgeon for three to five years, then trains for at least three more years in plastic surgery. Training involves closely supervised continuous evaluation and management of many complex clinical situations, and matures the surgeon personally and professionally. Successful completion of the post-graduate residency years qualifies the surgeon for written and oral examinations administered by the American Board of Plastic Surgery. Surgeons must submit an entire year of his or her surgical accomplishments for the exam. Surgeons are not eligible for the exam until they have been practicing plastic surgery independently for two years or longer.

There are no such requirements for Cosmetic Surgeons. Cosmetic surgeons are doctors who merely decide to perform cosmetic surgery in their practice. They may be certified in any medical specialty such as a gynecology, dermatology, family physician, ear,-nose-throat, etc. Their training may consist of several short weekend courses to a one-year cosmetic surgery fellowship.

Because they know the difference! Board Certified Plastic Surgeons CAN perform both reconstructive and aesthetic/cosmetic surgery in hospital or outpatient surgery centers.

Cosmetic Surgeons are NOT privileged for cosmetic surgery at these facilities and are not allowed to perform reconstructive plastic surgery. For this reason, cosmetic surgeons usually perform surgery in office based operating rooms which are subject to more relaxed accreditation standards.